Prescription Drugs, age 65 and Medicare Part D

February 29th, 2012 Kelley Jensen

At age 65, many people find themselves using prescription drugs to maintain their health and well being. But, as we approach 65 and become eligible for medicare, our resources and methods of paying for prescription drugs change. Here are some common questions about Medicare Part D, as well as information about medicare supplemental insurance. Do you need medicare explained?

Where your previous medical coverage probably included prescriptions, the Medicare drug coverage is a separate, Part D plan (PDP) and there’s over 30 plans available, but there is an easy to use plan finder tool:

Contact Medicare Rx (800) 633-4227 www.medicarerx.gov By providing your home zip code and list of prescriptions, you’ll be directed to the best Rx plan for your needs. I suggest that people go to the website and call simultaneously so a representative can walk them thru. Once you have your Medicare eligibility established, then you can enroll in an Rx plan right then over the phone. Here’s the specific link:

Once you’ve entered your Rx list and preferred pharmacy, the first thing the tool will tell you is the retail cost of your drugs and then it will sort all 30 programs by lowest annual cost. As an example, let’s say you take three maintenance drugs, the annual cost might be $2000 retail, the plan finder will identify your best plan choice and share of cost under that plan, a dollar figure like $700 which includes the plan’s monthly premium.

Two important things to note here. One is that the lowest monthly plan premium isn’t necessarily the best choice, the tool correctly uses total out of pocket cost as the decision criteria. Second, the tool creates a ‘snapshot’ based on the drugs you take today, not what could happen tomorrow (that’s what I refer to as crystal ball stuff). But you can rest assured that all of the Rx plans by law have drug treatment available for any and all diagnoses, you cannot be left without drug therapy. And each year you will be given the chance to change or upgrade your plan if your needs change.

When planning for the future, how does your family fit in? Do you need family health insurance plans? Health insurance for college students? Short term life insurance? related article.

Should your adult children be on your health insurance plan? Read this.

What if I don’t need Prescription medicines?

Lastly, people sometimes say, “I’m not taking any drugs, why do I need to pay for an Rx plan?” In that situation, I strongly recommend a “safety net”. Humana has a base plan for around $15 per month that will be there for you in this scenario: if you’re diagnosed mid-year and given a laundry list of drugs, you’ll have coverage. If you didn’t elect a drug plan for the year, you’d have to wait until the following January to add a plan, until then you’d be on your own. The peace of mind is worth $15. Here’s their link:

Note that the plan is called the Humana Walmart Plan, but it doesn’t mean you need to shop at Walmart. You’ll be able to choose from many other pharmacies or mail order providers.